在肯尼亚内罗毕县选定诊所就诊的成年肺结核患者中,COVID-19 疫苗接种率以及个人层面的促进因素和障碍

Boru Waqo, George Makalliwa, Caroline Musita
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摘要

背景 虽然疫苗接种是遏制传染病传播的有效公共卫生干预措施,但疫苗接种率低是一个值得关注的重大问题,尤其是在高危人群中。在结核病和 COVID-19 负担最重的内罗毕,近一半的人口未接种疫苗,但却缺乏结核病患者的疫苗接种信息。接种率受多种因素的影响,保护这一弱势群体和普通人群免受严重疾病、住院治疗和死亡的危害是非常重要的。本研究旨在确定在肯尼亚内罗毕县选定诊所就诊的成年肺结核患者中,COVID-19 疫苗接种的普遍程度以及个人层面的促进因素和障碍。方法 这项横断面混合方法研究在内罗毕县六个分县的结核病诊所进行。研究对象包括从各诊所结核病登记册中抽取的 388 名参与者。定量数据通过问卷收集,定性数据通过关键信息提供者访谈和焦点小组讨论收集。定量数据采用描述性统计(分类变量的频率和百分比,连续变量的平均标准偏差)和推断性统计(逻辑回归)进行分析。定性数据通过演绎编码和主题分析进行分析。结果 COVID-19 疫苗接种率为 46.1%,其中 38.1%接种完全。对疫苗管理的不信任(调整后比值比 (aOR)= 0.075,95% 置信区间 (CI):0.025-0.229,p <0.001)是阻碍COVID-19疫苗接种的一个重要因素。认知的 COVID-19 易感性(aOR = 2.901,95% CI:1.258-6.688,p = 0.012)和认知的 COVID-19 严重性(aOR = 3.294,95% CI:1.130-9.604,p = 0.029)是 COVID-19 疫苗接种的重要促进因素。定性主题涉及个人层面的障碍(对副作用的恐惧、耻辱感、神话和不信任)和促进因素(保护他人的愿望和风险认知)。结论 COVID-19 疫苗在肯尼亚内罗毕肺结核患者中的接种率较低,不信任是阻碍因素,风险意识是促进因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prevalence and individual level enablers and barriers for COVID-19 vaccine uptake among adult tuberculosis patients attending selected clinics in Nairobi County, Kenya
Background Although vaccination is impactful public health intervention in curbing the spread of infectious disease, low uptake is a significant concern, especially among high-risk population groups. Nearly half of the population is unvaccinated in Nairobi with highest TB and COVID-19 burden, yet there is dearth of vaccination information on tuberculosis patients. The interplay of several factors influences uptake, and protecting this vulnerable group and the general population from severe disease, hospitalization, and deaths is worthy. The study sought to determine the prevalence and individual level enablers and barriers for COVID-19 vaccine uptake among adult Tuberculosis patients attending selected clinics in Nairobi County, Kenya. Methods This cross-sectional mixed-method study was conducted at Tuberculosi clinics across six sub-counties in Nairobi County. It included 388 participants sampled from each clinic’s Tuberculosis register. Quantitative data was collected using a questionnaire, and qualitative data was collected through key informant interviews and focus group discussions. Quantitative data was analyzed using descriptive statistics (frequencies and percentages for categorical variables and mean standard deviation for continuous variables) and inferential statistics (logistic regression). Qualitative data was analyzed through deductive coding and thematic analysis. Results The prevalence of COVID-19 vaccination was 46.1%, with 38.1% receiving complete vaccination. Mistrust in vaccine management (adjusted odds ratio (aOR)= 0.075, 95% confidence interval (CI): 0.025-0.229, p <0.001) was a significant barrier to COVID-19 vaccine uptake. Perceived covid-19 susceptibility (aOR = 2.901, 95% CI: 1.258-6.688, p = 0.012) and perceived covid-19 seriousness (aOR = 3.294, 95% CI: 1.130-9.604, p = 0.029) were significant enablers of COVID-19 vaccine uptake. Qualitative themes related to individual-level barriers (were fear of side effects, stigma, myths, and mistrust) and enablers (desire to protect others and risk perception). Conclusions Low COVID-19 vaccine prevalence, mistrust as barrier and risk perception as enablers for COVID-19 uptake among TB patients in Nairobi, Kenya.
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